Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)

Article

Pilot implementation of Workplace Based Assessment in undergraduate medical training: Are Mini-CEX and DOPS feasible at this educational level and how satisfied are the participants with these two tools?

Outline

Questions: The Mini Clinical Evaluation Exercise (Mini-CEX) and the Direct Observation of Procedural Skills (DOPS) are helpful tools for Workplace Based Assessment (WPBA) to foster clinical competencies in postgraduate medical training. However, little is known about its use in the undergraduate setting. We were piloting the implementation of the Mini-CEX and DOPS in undergraduate medical training at the University of Berne. Within the curriculum reform, it will become mandatory to perform 3 WPBAs during the 4 weeks clinical clerkships in the following specialities: internal medicine (2 Mini-CEX/1 DOPS), paediatrics (2 Mini-CEX/1 DOPS), gynaecology/obstetrics (2 Mini-CEX/1 DOPS), psychiatry (3 Mini-CEX) and surgery (1 Mini-CEX/2 DOPS). We aimed at answering the following questions:

1.

Are 3 WPBAs per month and student feasible in undergraduate medical training?

2.

How satisfied are students and teachers with these two tools?

Methods: Within this pilot study, the Mini-CEX and DOPS were introduced in 4 pilot clinics: internal medicine, paediatrics, gynaecology/obstetrics and psychiatry (surgery will follow in a second phase). Supervising physicians were trained in an interactive workshop and received written instructions about the rating scale and giving feedback. Frequency of assessments and satisfaction of participants in undergraduate medical training were analysed descriptively, free comments were analysed qualitatively.

Results: In total, 42 Mini-CEX und 15 DOPS were performed in the 4 pilot clinics (19 students, 19 supervisors). All students completed the required number of assessments. Participants indicated a higher satisfaction with the Mini-CEX compared to the DOPS: students 7.1 Â± 1.8 SD for Mini-CEX, 5.7 Â± 2.7 for DOPS; teachers 7.2 Â± 1.3 for Mini-CEX, 6.2 Â± 2.3 for DOPS (1 = very low, 10 = highest satisfaction). In paediatrics DOPS were generally applied for paperwork (i.e. discharge reports) and not for practical skills, as it was intended. Students’ free comments indicated that they regarded the Mini-CEX as more useful than the DOPS for undergraduate medical training, as procedural skills – especially in paediatrics – were limited at this educational level.

Conclusions: Workplace Based Assessment is feasible in undergraduate medical training in clinics from varying specialties – even the relatively high number of 3 assessments/month/student see ams to be feasible in daily clinical routine. Participating students and teachers alike were satisfied with the Mini-CEX and DOPS. In paediatrics, the application of DOPS seams to be difficult at this educational level. Further research is needed to answer the question whether Mini-CEX are generally more appropriate for formative assessment in undergraduate medical training than DOPS.